Cystic fibrosis pancreatitis

A cystic fibrosis pancreatic adenocarcinoma cell line. Proc Natl Acad Sci USA 87 4012-6. 

Pancrelipase Replacement enzymes from animal pancreatic extracts Improves digestion of dietary fat, protein, and carbohydrate Pancreatic insufficiency due to cystic fibrosis, pancreatitis, pancreatectomy Taken with every meal may increase incidence of gout... 

Enzyme therapy has also been tested for pancreatic insufficiency and cystic fibrosis. Pancreatic insufficiency can be alleviated by administrating orally enteric-coated microspheres containing lipase, amylase, and proteases. A special polymer coating protects the enzymes at low pH, such as in the stomach, and then releases them in the intestine at physiological pH.""" ... 

These drug are prescribed as replacement therapy for those with pancreatic enzyme insufficiency. Conditions or diseases that may cause a decrease in or absence of pancreatic digestive enzymes include cystic fibrosis, chronic pancreatitis, cancer of the pancreas,... 

Cystic fibrosis (CF) is a recessive genetic disorder prevalent among whites in North America and certain parts of northern Europe. It is characterized by chronic bacterial infections of the airways and sinuses, fat maldigestion due to pancreatic exocrine insufficiency, infertility in males due to abnormal development of the vas deferens, and elevated levels of chloride in sweat (> 60 mmol/L). 

Excessive secretion of gastric acid, associated with Helicobacter pylori infection, can result in the development of gastric and duodenal ulcers small changes in the composition of bile can result in crystallization of cholesterol as gallstones failure of exocrine pancreatic secretion (as in cystic fibrosis) leads to undernutrition... 

CP-channels with smaller conductance have first been noted in the rectal gland of Squalus acanthias by ourselves and in the colonic carcinoma cell line HT29 [61,73]. Later these types of 5-15 pS CP-channels were also found in pancreatic ducts, A6-cells and many other cells [74,75]. It is now claimed that this kind of channel is much more relevant than the ICOR for the pathophysiology of cystic fibrosis [12]. 

Human leukocyte elastase is a protease that degrades elastin and other connective tissue components. It is implicated in the pathogenesis of pulmonary emphysema and other inflammatory diseases such as rheumatoid arthritis and cystic fibrosis. Porcine pancreatic elastase has often been used as a model for HLE. Both enzymes have a small primary binding site Si. 

The incidence of chronic pancreatitis is approximately 1 in 10,000 people. O The most common cause of chronic pancreatitis in adults in Western countries is ethanol abuse. The most common cause in children is cystic fibrosis, due to preexisting pancreatic insufficiency inherent in the disease. Gallstones can occur at the same time as chronic pancreatitis but are not often implicated as the cause. Unlike acute pancreatitis, chronic pancreatitis has an unknown etiology in a significant number of cases (30%).29,3°... 

The pancreas, in which the mucus blocks its ducts in 85 per cent of cystic fibrosis patients, causing pancreatic insufficiency. This is chiefly characterized by secretion of greatly reduced levels of digestive enzymes into the small intestine. 

Pancreatin is a pancreatic extract usually obtained from the pancrease of slaughterhouse animals. It contains a mixture of enzymes, principally amylase, protease and lipase, and, thus, exhibits a broad digestive capability. It is administered orally mainly for the treatment of pancreatic insufficiency caused by cystic fibrosis or pancreatitis. As it is sensitive to stomach acid, it must be administered in high doses or, more usually, as enteric-coated granules or capsules that may be taken directly or sprinkled upon the food prior to its ingestion. Individual digestive activities, such as papain, pepsin or bromelains (proteases), or a-amylase are sometimes used in place of pancreatin. 

Cystic fibrosis can obstruct pancreatic ducts due to mucous plugging and impaired secretion of pancreatic enzymes such as lipase and phospholipases, which decreases hydrolysis and uptake oftri-acylglycerols. 

Deficiencies characterized by excessive bleeding may occur in infants due to their lack of intestinal bacteria or In adults having fat malabsorption disorders, such as cystic fibrosis, which result in insufficiency of pancreatic lipase secretion. 

Pancreatic enzyme replacement or supplement when enzymes are absent or deficient, such as with chronic pancreatitis, cystic fibrosis, or ductal obstruction from cancer of the pancreas or common bile duct to reduce malabsorption treatment of steatorrhea associated with bowel resection or postgastrectomy syndrome PO 1-3 capsules ortablets before or with meals or snacks. May increase to 8 tablets/dose. 

Steatorrhea occurs in patients whose lipase output is at 10% or less of normal. Lipase and other pancreatic enzyme insufficiencies are observed in cystic fibrosis and chronic alcoholic pancreatitis. Patients with various liver diseases may also present with steatorrhea [18]. For these patients, pancreatic enzymes—mainly lipase, protease, and amylase—extracted with alcohol from porcine pancreases have been shown to provide amelioration of diarrhea. These enzymes are enriched and formulated in... 

Exocrine pancreatic insufficiency is most commonly caused by cystic fibrosis, chronic pancreatitis, or pancreatic resection. When secretion of pancreatic enzymes falls below 10% of normal, fat and protein digestion is impaired and can lead to steatorrhea, azotorrhea, vitamin malabsorption, and weight loss. Pancreatic enzyme supplements, which contain a mixture of amylase, lipase, and proteases, are the mainstay of treatment for pancreatic enzyme insufficiency. Two major types of preparations in use are pancreatin and pancrelipase. Pancreatin is an alcohol-derived extract of hog pancreas with relatively low concentrations of lipase and proteolytic enzymes, whereas pancrelipase is an enriched preparation. On a per-weight basis, pancrelipase has approximately 12 times the lipolytic activity and more than 4 times the proteolytic activity of pancreatin. Consequently, pancreatin is no longer in common clinical use. Only pancrelipase is discussed here. 

Pancreatic enzyme supplements are well tolerated. The capsules should be swallowed, not chewed, because pancreatic enzymes may cause oropharyngeal mucositis. Excessive doses may cause diarrhea and abdominal pain. The high purine content of pancreas extracts may lead to hyperuricosuria and renal stones. Several cases of colonic strictures were reported in patients with cystic fibrosis who received high doses of pancrelipase with high lipase activity. These high-dose formulations have since been removed from the market. 

Abnormalities in protein digestion In individuals with a deficiency in pancreatic secretion (for example, due to chronic pancreatitis, cystic fibrosis, or surgical removal of the pancreas), the digestion and absorption of fat and protein is incomplete. This results in the abnormal appearance of lipids (called steatorrhea, see p. 175) and undigested protein in the feces. 

Children with cystic fibrosis lose excessive amounts of salt in perspiration and become dehydrated readily. A salty taste of the skin and an elevated chloride concentration of sweat are traditional diagnostic symptoms.3 More serious problems arise from progressive respiratory failure and inadequate pancreatic secretion. Lung infections with Pseudomonas aeruginosa are the major cause of death. The CFTR gene is expressed in many tissues, especially those of the mucous membranes. 

Cystic fibrosis - [PHARMACODYNAMICS] (Vol 18) - [IRACE AND RESIDUE ANALYSIS] (Vol 24) -chloride disorder [MINERAL NUTRIENTS] (Vol 16) -use of pancreatic enzymes [ENZYMEAPPLICATIONS - THERAPEUTIC] (Vol 9)... 

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